Viewer`s Guide

Viewer’s Guide
1. Introduction.………............................................................................3
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Note from the Filmmaker
Note from GlaxoSmithKline
How to Use this Guide
2. The Story of Partners of the Heart ......................................................7
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Summary of the Blalock-Thomas Story
In His Own Words: Vivien Thomas
Success Story: Levi Watkins, Jr.
3. For Students.………………………………………………………...12
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A History of the Heart
Medical Science in a Social Context
In His Own Words: A Cardiac Surgeon Reflects
In Their Own Words: “Blue Babies”
From Molecule to Marketplace: Making Medicine
Success Stories: Henry Wall, Rodney Hood, Bevin Engelward,
Maria Terésa Tarragó-Trani
4. For the Classroom .............................................................................28
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Two Kinds of Segregation
In His Own Words: Nat Crippens
Two Early Activists for Civil Rights
Discussion Questions, Activities
5. More Activities……………………………………………………...34
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Finding Local Heroes
Culturally competent medicine
Success Stories: Phua Xiong, Lydia DeSantis, Maurice
Iwu, Benjamin Young
In His Own Words: A Mentor’s Legacy of Confidence
6. Resources……… ..............................................................................42
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Scholarships, Books, Websites, Organizations, Other Resources
7. Acknowledgments ............................................................................45
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1.
Introduction
Filmmaker’s Note
It has taken nearly a decade to bring you Partners of the Heart. More than ever, I am inspired
by Vivien Thomas’ upward journey and his ability to persevere long enough to prevail over a
system that challenged his identity and denied him opportunity.
His story provoked me — and I hope will move you — to gain a better understanding of this
country’s personal and institutional legacy of racism. To move forward, we need to reckon with
the history of a society that permitted Thomas to stand at Dr. Blalock’s shoulder in the operating
room but denied him a place at the dinner celebrating Blalock’s 60th birthday party at a posh and
segregated Baltimore hotel.
Vivien Thomas’ story also serves as a sharp reminder of what society loses when a person is
denied opportunity because of his or her race, religion, gender, etc. Like Thomas, many people,
even today, need only an opportunity to show what they’re capable of contributing.
This story also shows the importance of individual effort. As an individual, Vivien Thomas was
as pragmatic and no-nonsense as the surgical tools he developed and passed on to others. He was
hooked on the process of discovery and the quest for answers that really mattered. It was this
passion for science that forged the bond between Thomas and Blalock and that would leave a
life-saving legacy for generations to come. Their collaboration provides a framework for
understanding how individual partnerships can break down society’s barriers.
As we address issues of diversity and tolerance, and learn to appreciate the contributions of all
Americans, Partners of the Heart provides an important story of African American
achievement and the rich possibilities inherent in cooperation. My hope is that this film will
spark a dialogue and will advance our struggle to understand race, history and who we are. In the
very making of Partners of the Heart we went through this process ourselves.
Andrea Kalin
Producer/Director/Co-Writer
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Note from GlaxoSmithKline (GSK)
Sponsor of educational outreach for Partners of the Heart
When I first saw the film Partners of the Heart, I was very moved by Vivien Thomas’s life
story. Here was an individual who wouldn’t take no for an answer. He identified what he wanted
to do with his life, and although his ultimate goal was not directly available to him, he was able
to pursue it through a different route. Vivien Thomas set a tremendous example for other people:
that anyone can be successful; it just takes effort and commitment. Thomas is an unsung hero
and his story needs to be told. I am proud that GSK has established a scholarship in Vivien
Thomas’ name to honor his life’s achievements. (http://www.cbcfinc.org/gsk_scholarship.html)
Another aspect of the film that I find compelling is the relationship between Thomas and Dr.
Alfred Blalock. That the two men were able to work together ― a black lab technician and a
white surgeon ― at a time when society’s rules kept them apart outside the medical laboratory,
says something about the power of discovery. They each were truly excited by what occurred in
the lab, and this is partly what allowed them to ignore all else and focus on their work.
Scientists at GlaxoSmithKline (GSK) share a similar enthusiasm for their work discovering new
medicines. Not only is the process of scientific discovery exciting, but it is also rewarding. It
takes years, sometimes decades, of work before a medicine finally appears on the shelves of a
pharmacy. Knowing that new medicines can save lives and help people feel better is what keeps
researchers like Henry G. Wall committed.
You’ll find Dr. Wall, a GSK researcher, among the success stories included in this Viewer’s
Guide. Like Vivien Thomas, Dr. Wall, an African American, grew up in difficult circumstances
and faced many obstacles, but he persevered and ultimately achieved success.
Partners of the Heart tells a story of a great American who dedicated his life to cardiac surgery
that benefited thousands of people who would not have been saved without his contributions and
persistence. And my message to you is that individuals can make a difference. Don’t sit back and
wait to be recognized. Do the very best job you can do — and your work will speak for itself.
Stan Hull
Senior Vice President, US Pharmaceuticals
GlaxoSmithKline
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With thanks to our community and educational outreach sponsor, GlaxoSmithKline.
is at the core of a new program, GlaxoSmithKline Healthy CommunitiesTM,
designed to promote awareness of asthma, diabetes, hypertension, HIV/AIDS and prostate
disease (BPH) ― conditions that disproportionately affect African Americans. Inspired by
the life of Vivien Thomas, GlaxoSmithKline Healthy CommunitiesTM also will help support
African American youth in pursuing careers in medicine and science.
5
How to Use this Guide
This booklet is intended for three main audiences:
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high-school students who want to find out more about the film’s story and what it means
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teachers who want to use the film in classes on science, history or social studies
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anyone who wants to know about mentoring programs that can link young people to careers in science and
medicine
For all viewers, Section 2 summarizes the story, offers Vivien Thomas’ view of the relationship
and shows some of the partnership’s impacts, including the effect on young people like Levi
Watkins, Jr.
Throughout this guide you’ll find short success stories — profiles of people who have overcome
obstacles of ethnic bias, gender bias and economic hardship, and who went on to make important
contributions in health and medical science. Their stories bring the film’s message into the
present and show the range of paths available in broad fields like medicine.
For students, Section 3 looks at the science and history of the human heart and how medicine
has treated it through many cultures and eras. Through the reflections of “blue babies” and four
success stories, we also look at how medicine isn’t just about science, it’s about people.
Section 4 offers classes historical context for the Partners story, both in the structures of racial
segregation and in the stories of early activists who spoke out for equal rights in the American
South. The two stories told by Nat Crippens bring that history to life-and-death reality.
Teachers should pick the readings that best suit the dialogue they wish to explore. Objectives
might include having students analyze the effects of racial segregation on the history of
medicine, or having science students discuss the impact of the blue-baby operation on the
development of medicine today. The discussion questions can help bring out themes in science
and history.
For more classroom activities, Section 5 moves from the school to the neighborhood. How can
we find and appreciate the local heroes who live around us? How can medical professionals best
respond to the communities around them? Through success stories involving Hmong (Southeast
Asian), West African and Hawaiian cultures, we see how medicine can reflect a community and
better serve its people.
In the last section, you will find a list of resources for learning, links for more information about
the people profiled here and sources on mentoring for careers in science and medicine. For more
paths into this rich story, see the DVD version of Partners of the Heart or visit the website at
www.pbs.org/wgbh/amex/partners/.
6
The Story of Partners of the Heart
a derogatory term for blacks and their forced
separation from whites. Jim Crow laws were
enacted throughout the South in the 1870s from a
racist idea of “purity.” Schools, parks, public
transportation, theaters, restaurants, even cemeteries
had to keep whites and blacks separated. In 1954
the U.S. Supreme Court ruled that such laws were
unconstitutional.)
tells the story of Alfred Blalock
and Vivien Thomas and how they, with Helen
Taussig, helped to invent heart surgery.
How did they get the nerve to cut into the heart of a
sick baby? How did they even work together? At
the time, a black man and a white man could get
arrested for just eating together in public.
In the privacy of the lab, though, the two men could
talk over experiments. Vivien Thomas didn’t have
the advantages of Blalock’s background and college
education, but he had an excellent high school
education, and in his work as a carpenter he had
perfected a craftsmanship that would prove amazing
in surgery. While working in the lab, Thomas
studied science on his own and gradually did more
and more of the operations in the animal laboratory
himself, testing Blalock’s theories about surgical
shock. His drive for knowledge was important for
the success of their experiments. Their research in
Nashville created a new understanding of how
shock happened. They showed that shock was
caused by a loss of blood and plasma and that the
body required transfusions to prevent shock during
operations. This was revolutionary.
Alfred Blalock came from a white Southern
aristocratic family in Georgia. Vivien Thomas was
born in Louisiana and grew up in Nashville; his
father was a master carpenter in the African
American community. The two men met in 1930,
when Blalock was a 30-year-old surgeon and
Thomas was 19 years old. Thomas applied for a job
in the medical laboratory of Vanderbilt University
in Nashville. Blalock hired him.
Blalock was a professor, busy doing research,
operating on patients and teaching medical students.
He needed an assistant, he told Thomas, whom he
could “teach to do anything I can do, and maybe do
things I can’t do.” Thomas took the job to save
money for college and medical school. He had lost
all his savings from carpentry jobs when banks
failed after the Stock Market Crash of 1929.
In 1940 Blalock accepted a job as the head of the
surgery department at the medical school of Johns
Hopkins University in Baltimore. By that time,
Blalock was convinced that Vivien Thomas was
essential to his research. He insisted that Johns
Hopkins hire Thomas too, even though the
university had no African Americans on its
professional staff. Like Nashville, Baltimore was
segregated. As a black man, Thomas could “stop
traffic” just by walking down the hall in a white lab
coat and he was barred from eating in the same
cafeteria as the hospital’s white staff.
Despite their differences in race, background and
personality (Blalock had a quick temper, Thomas
was very calm and slow to anger), Alfred Blalock
and Vivien Thomas shared a deep commitment to
excellence, and a belief in medicine. The
combination of Blalock’s grasp of medical theory
and willingness to challenge assumptions and
Thomas’ technical expertise and innovative
problem-solving skills made them a dynamic
research team.
At Hopkins, the two men worked with Helen
Taussig, a pediatric surgeon who wanted to fix a
congenital heart defect called Tetralogy of Fallot.
The condition limited the oxygen in afflicted
children’s blood, made them short of breath and
gave their skin a bluish appearance. Blalock,
Thomas and Taussig developed the “blue baby”
operation, a surgical procedure that rearranged the
At that time, under the rules of racial segregation —
mainly in the South but to varying degrees
nationwide — they could not see each other outside
the lab. Under Jim Crow laws, it was illegal for
whites and blacks to meet socially, to date, even to
share a meal. (“Jim Crow” was the name of a
minstrel routine in the mid-1800s and later became
7
blood vessels connecting a child’s heart and lungs
to increase the oxygen in the blood. Thomas tested
the procedure and perfected it in the animal
laboratory; finally they decided they were ready to
try it on Taussig’s patients. Blalock conducted the
operation in November 1944, with Thomas advising
him at each step. The success made headlines
around the world and launched the modern era of
heart surgery. The operation paved the way for
open-heart surgery and heart transplants.
Baltimore. Later, Thomas tutored young black
students and introduced them to medical careers. In
1971 Johns Hopkins finally recognized Thomas’
historic role when his former students of surgery
commissioned a portrait of him to hang in a place of
honor, near Blalock’s portrait. The university also
gave him an honorary doctorate degree.
Levi Watkins, Jr., was one of Thomas’ students.
Watkins came to Johns Hopkins in the 1970s as an
intern and later joined the faculty. One day in the
cafeteria, Watkins noticed another black man and
recognized him from a portrait that hung in the
medical building, near Blalock’s picture. “As soon
as I saw him, I remembered there was this picture of
this man in the hall,” Watkins said later. “I knew
black men didn’t have their pictures on the walls of
Johns Hopkins. So I asked him who he was,
because I knew he was somebody extraordinary.”
From that first meeting in the cafeteria, Vivien
Thomas helped to lead Watkins through his first
years at Johns Hopkins. Later, Levi Watkins opened
the medical school up to many more people of
color.
Thomas and Blalock pioneered advances in
medicine, but the partnership was still held back by
segregation. Thomas got no credit for his role in the
breakthroughs until decades later. For most of his
life he struggled to provide for his family and his
children’s education. When Thomas went to a party
at the Blalocks’ house, he went as a bartender, to
earn extra money. In 1961, when Blalock’s
colleagues threw a big party to celebrate his 60th
birthday at Baltimore’s premiere Southern Hotel,
the hotel still banned African Americans. Thomas
was not invited, despite a friendship and
collaboration of 31 years.
Neither man made a public statement about racial
equality. Still, their partnership helped pave the way
for social breakthroughs. Vivien Thomas’ presence
in the Johns Hopkins medical school encouraged
African American orderlies like Richard Scott, who
went on to study medicine and become a surgeon in
Vivien Thomas’ partnership with Alfred Blalock
was revolutionary in medical science. It was also
revolutionary in another way: they worked together
as individuals, looking past the divisions of race to
create knowledge and healing.
8
In His Own Words:
Vivien Thomas
On learning perfectionism, at age 19:
On a carpentry job, I was to remove the worn piece
of flooring and match the color and grain to the
remaining floor. Shortly after noon my foreman
came by to inspect. He took one look at the floor
and said, “Thomas, that won’t do. I can tell you put
it in.” Without another word, he turned and left the
house. I was stung, but I replaced the piece of
flooring. This time I could barely discern which
piece I had put in…Several days later, walking
along with him to another job site, he said to me,
“Thomas, you could have fixed that floor right in
the first place.” I knew I had already learned the
lesson, which I still remember: whatever you do,
always do your best…I never had to repeat or redo
another assignment.
On first meeting Alfred Blalock:
In his life, Vivien Thomas focused on his medical
research and his family, and did not speak out on
social issues. But in his autobiography, published
just days after his death, he reflected on his
experiences. (The book, originally titled Pioneering
Research in Surgical Shock and Cardiovascular
Surgery: Vivien Thomas and His Work with Alfred
Blalock, was recently republished under the new
title Partners of the Heart: Vivien Thomas and His
Work with Alfred Blalock.) These excerpts tell us
what he thought about life, his ideals, the pursuit of
excellence and his partnership with Alfred Blalock.
I was favorably impressed by Dr. Blalock and his
friendly, relaxed and informal manner in the
interview and by the amount of time he spent
explaining his experiment to me...Though I did not
fully appreciate it at the time, he knew exactly what
he wanted. Essentially what he said to me was: “I
want somebody in the laboratory whom I can teach
to do anything I can do and maybe do things I can’t
do.”
On contagious enthusiasm at Vanderbilt in
the early 1930s:
For me this was a time of hard work and study to
become familiar with and use the additional
apparatus and equipment to learn all the various
techniques and methods required in the studies that
followed. The volume of work each day was
tremendous. Besides having an experiment in
progress, the chemical analyses from the previous
day’s experiment were being done. And the days
were long; there was no 8 a.m. to 5 p.m. during
these studies. I don’t know when Dr. Beard
[another Vanderbilt surgeon and mentor to
Thomas] slept; I would leave him in the laboratory
at 6 or 7 p.m. Dr. Blalock would often leave even
later…I did not realize that enthusiasm was
contagious until I found that I didn’t mind if I
occasionally had to cancel some social activity. I
had obviously ‘caught’ it from Dr. Beard.
On his first mentor:
My father took advantage of the propensity of boys
to hammer on things and brought us up in his own
trade of carpentry…During the summer, work hours
were from 7 a.m. to 5:30 p.m. I began reporting for
work when I was thirteen. He started us out with
nailing. Next, he would have us sawing (no electric
saws) to lines he had made to measure on the
lumber. The day would soon come when we were
doing our own measuring, making our own lines,
sawing, and nailing. Gradually we went on to finish
and trim work, learning to fit and hang doors,
installing locks on them, and putting in inside
stairways and banisters. As he had done with my
brothers, my father had me working almost
independently by the time I was 16 years old.
9
Larsen, Resident in Surgery, with something he was
doing. He told me in no uncertain terms, with
Larsen listening, “You are my technician and you
are not to help anyone.” I got the word but, if I
knew Dr. Blalock was busy elsewhere or was out of
town, I would help anyone if I had the time
available. I was interested and curious about
everything that went on in the laboratory. The
interest and curiosity still remain with me.
On how he taught himself surgery
in the 1930s:
…I would scrub up, prepare, and drape the
anesthetized animal. When Dr. Blalock came in to
scrub, he would have me begin the incision…One
day he didn’t make his schedule. I waited a while,
made the incision, and covered it with moist gauze.
I waited some more. Ten to fifteen minutes later he
came in. “Sorry, I got tied up,” he said. On another
day, I made the incision and waited thirty minutes.
After forty-five minutes, when he still had not come,
I went ahead with the procedure and slowly and
painstakingly struggled on through alone. He came
in just as I was ready to close the incision. After
looking over what I had done, he asked who had
helped me. I said no one and Sam [a lab assistant]
confirmed my reply.
On tackling the toughest problems:
I had never seen or examined a defective heart, and
what I actually saw defies verbal description except
in highly technical terms. I was amazed that some
of these patients had survived as long as they
had…While attempting procedures on an earlier
project that had been particularly difficult, I had
asked the Professor why he didn’t find some easier
projects. He replied that all the easy things had
been done. The reproduction of any of the
conditions that existed in these congenitally
defective hearts would surely not be easy.
On racism and his partnership
with Dr. Blalock:
In 1937 Dr. Blalock told me that he was
considering an offer to go to Henry Ford Hospital
[in Detroit], as Chief of Surgery, and that if he
accepted, he wanted me to go with him. I wrote an
older sister, Olga T. Calhoun, who lived in Detroit,
telling her of the possibility that I might be coming
there. She wrote back and told me not to get my
hopes too high, that Henry Ford was strictly lily
white, and that it was worse than anything she had
seen, even though she had grown up in the South.
Some time later, Dr. Blalock said simply, “We
won’t be going to Detroit.” He made no further
comment and gave no reason for turning down the
offer… It has been said and written that the position
was turned down because, as my sister had
suspected, I was not acceptable to them and that I
was a part of a sort of package deal that Dr.
Blalock had proposed.
On the earning power of a college
education for his children:
Almost everyone I talked with was ready to give me
a job [as a carpenter, in the construction boom
after World War II]. There simply were not enough
carpenters to meet the demand. It was quite a
temptation…I told him we were planning to move
back to Nashville the following spring…Our dialog
went essentially like this:
BLALOCK: What’s the matter, don’t you like it
here?
THOMAS: I want to give my children a better
chance than I had and give them as much education
as they want, but I won’t be able to if I stay here at
Hopkins.
BLALOCK: (whining) Well, Vivien, you’re making
more money now than anyone around here without
a degree…
THOMAS: That’s the problem, that’s the reason I
plan to be able to let my children get all the degrees
they want…
On intellectual curiosity and his work:
Dr. Blalock was strictly opposed to my helping
anyone in the laboratory. I first learned of this
around 1934-35. Dr. Blalock came into the
laboratory one day and found me helping Dr. Ralph
10
Success Story: Levi Watkins, Jr.
remembered there was a picture of this man in the
hall,” Watkins recalled later. “I knew right away he
was somebody of importance. It was a kind of
funny feeling … because I knew black men didn’t
have their pictures on the walls of Johns Hopkins.”
The two became good friends and Thomas guided
the younger man in the ways of Hopkins.
From 1973 to 1975, Watkins interrupted his
surgical training to conduct cardiac research at
Harvard Medical School. His research on the role of
the renin angiotensin system in congestive heart
failure was a breakthrough and led to new treatment
for heart failure.
Field: Cardiac Surgery
Focus on surgery and broader participation:
Back at Hopkins, he became the university’s first
black chief resident in cardiac surgery. In 1978
Watkins joined the faculty as an associate professor
and the next year he joined the medical school’s
admissions committee. He wanted to increase the
participation of minorities at the medical school,
and in just four years, minority representation
quadrupled among students. In 1983 he was
appointed to the National Board of the Robert
Wood Johnson Minority Faculty Development
Program, which aims to increase the number of
minority faculty members across the country.
Dr. Watkins was the first surgeon to implant an
internal defibrillator, which automatically detects
irregular heart rhythms and corrects them. He
became the first African American chief resident in
cardiac surgery at Johns Hopkins.
Beginnings: Levi Watkins, Jr., was born in Parsons,
Kansas, the third of six children. His father was a
college professor who moved the family to
Alabama to become president of Alabama State
University. The minister of the family’s church in
Montgomery was Dr. Ralph Abernathy, the civil
rights leader. In high school, Watkins joined the
Dexter Avenue Baptist Church, led by Dr. Martin
Luther King, Jr. At Dr. King’s request, Watkins
drove the church station wagon on Sunday
mornings. He played an active role in the
Montgomery bus boycotts of the 1950s.
Another First: Soon after he joined the surgical
team at Johns Hopkins Hospital, Watkins performed
an operation that captured international attention.
In February 1980, he became the first surgeon to
implant an automatic defibrillator into a human
heart. This treatment has since saved the lives of
more than 100,000 people who suffered from a
dangerously irregular heartbeat.
Then What?: Watkins attended Tennessee State
University and, inspired by what he’d seen at Dr.
King’s side, he “felt it was time Vanderbilt was
integrated.” In May 1966 he became the first
African American ever admitted to Vanderbilt
University’s medical school. He found out that he
was accepted from a headline in the Nashville
newspaper.
In 1991 Watkins was made a full professor of
cardiac surgery and within months was appointed
dean for postdoctoral programs and faculty
development for the medical school. In that role he
has helped to make postdoctoral education in
America more dynamic. His life has been featured
in magazines and national television programs.
In 1970 Watkins began a surgical internship at
Johns Hopkins University Medical School. There he
met Vivien Thomas, who was head of the surgical
research laboratory. “As soon as I saw him, I
11
through the body, propelled by the pumping heart.
The idea is a major breakthrough and revolutionizes
the way people think about the human body.
3. For Students
A History of the Heart
Late 1800s C.E. “Heart Surgery Can Go No
Further”
The long path of discovery that led to the
pioneering “blue-baby” operation by Alfred
Blalock, Vivien Thomas and Helen Taussig was
filled with advances and missteps. Here are eleven
steps in that journey and a look at the causes of
heart defects and disease today. Reflect on how
each step relates to the one before it.
“A surgeon who tries to suture a heart wound
deserves to lose the esteem of his colleagues,” said
Theodor Billroth in 1883. Like Billroth, most
physicians considered it foolhardy to treat heart
wounds. Later, Stephen Paget agreed: “Surgery of
the heart has probably reached the limits set by
Nature to all surgery; no new method, no new
discovery, can overcome the natural difficulties that
attend a wound of the heart.”
Eleven Steps to Knowing the Heart
2,500-1,000 B.C.E.
Judgment of the Dead
1890s Repair of Heart Wounds
Still, other surgeons attempted heart operations.
Henry Dalton and Daniel Hale Williams
successfully sutured cardiac wounds. There was a
high mortality rate, but innovators saw these and
other successful operations as hope for the future.
Most of the medical community disagreed.
The ancient Egyptians believed the heart, or the Ieb,
was the center of life and morality. Egyptian
mythology stated that after death, your heart is
taken to the Hall of Maat, the Goddess of Justice,
where it is weighed against the Feather of Maat. If
your heart is lighter than the Feather, you join
Osiris in the afterlife. If your heart is heavier, then
the demon Ammut eats your heart ― and your soul
vanishes from existence.
1938 Modern Heart Surgery Begins
Dr. Gross operated on the vessels near the heart in
an attempt to repair a defect in the pulmonary artery
of a young girl. This caused a sensation in the
newspapers. Doctors around the world took notice.
The era of modern cardiac surgery had begun.
130-200 C.E. Galen
Perhaps the most important of all ancient
physicians, Claudius Galenus was the personal
physician to the Roman Emperor, Marcus Aurelius.
Although Galen failed to understand things like
circulation, he noticed several important features of
the heart, including its valves and ventricles, and
the differences between veins and arteries.
1944 Blue Baby Operation
Alfred Blalock, Helen Taussig and Vivien Thomas
worked together in the first blue-baby operation, to
treat a fatal heart defect (its technical name is
“Tetralogy of Fallot”). The operation was a success
and introduced heart surgery as a viable option, not
just a last resort. World War II had brought
improvements in anesthesia, antibiotics and blood
transfusions, which helped pave the road toward the
Blalock-Taussig shunt.
100-900 C.E. Native America’s Heart
Early Americans recognized the importance of the
heart. The Teotihuacan Culture in ancient Mexico
believed that every human being contains several
different spiritual forces. Most of these may leave
the body at certain times, such as when one is
dreaming. However, the teyolia, the spiritual force
associated with the heart, must remain within the
body at all times or the person will die.
1628 C.E. William Harvey
In England, William Harvey published “An
Anatomical Study of the Motion of the Heart and of
the Blood in Animals,” which detailed for the first
time the idea of circulation and how blood travels
12
•
1952 First Open-Heart Surgery
•
there is a gap in the septum that normally separates the
left and right ventricles;
the valve that goes from the heart to the lungs is too
small;
the aorta “overrides” the defective septum; and
•
the wall of the right ventricle is too thick and hard.
•
At the University of Minneapolis Hospital, Dr. John
Lewis, assisted by Dr. Walter Lillehei, performed
the first successful open heart surgery. Using the
hypothermia approach, they sutured a hole in the
heart of Jacqueline Johnson.
This combination is a very rare congenital heart
defect. (Congenital means “present at birth.”)
Congenital heart problems affect about one child in
100. We don’t know for sure what causes these
defects — some may be caused by abnormalities in
a person’s chromosomes, others may occur because
the mother suffered an infection while she was
pregnant. You can find out more about heart disease
and health at www.heartpoint.com.
1960s Heart Transplants
With the development in the 1950s of the heart-lung
machine, which would take over the vital functions
of the body and allow a surgeon more time to
operate, cardiac surgeons became the celebrities of
medicine. Several, such as Walter Lillehei and
Henry Bahnson, lived up to the “work hard and play
hard” mentality. Denton Cooley became a legend in
Texas before he was 35. In 1967 in Cape Town,
South Africa, Dr. Christiaan Barnard performed the
first heart transplant, replacing the diseased heart of
a 55-year-old man with the healthy heart of a
woman who had recently died. The operation
launched onto the front pages around the world,
making a star out of Barnard.
Heart Disease: Did you know?
Heart defects are rare, but heart disease is the
leading cause of death in the United States. At least
58 million Americans (mostly adults) suffer from
some form of cardiovascular disease, including high
blood pressure. It is the No. 1 killer of women and
men. Heart disease and stroke used to afflict more
men than women, but since 1984, they have killed
more women than men. Stress, smoking, fatty foods
and inactivity are major factors contributing to this
increase.
Now Artificial Hearts
Experiments with artificial hearts have been around
since the mid-1950s. Despite several successes in
the 1980s, it wasn’t until the implantation of a
battery-powered heart by Michael DeBakey in1998
that many began to think of artificial hearts as the
way of the future.
Cardiovascular disease can hit anyone, regardless of
the person’s shape or size. Most types of heart
disease are caused by our own behavior, like poor
eating habits and lack of exercise. To sum it up, too
much of a good thing may kill us: tasty saturated
fat, sugar and television are just three. Even though
heart disease occurs mostly in adults, it can start
developing in children as young as 10 years old.
Medical Science in a Social Context
What Causes Heart Defects?
And what is a “blue baby”? Before birth, the human
heart starts as a simple tube. It then twists and
rotates and forms cavities and valves to become a
mature heart. When things go wrong (very rarely,
considering how complex it is), problems can range
from holes between the heart’s chambers to faulty
connections, or valves that don’t open properly.
The blue baby syndrome – Tetralogy of Fallot – is
actually four heart defects (“tetra” means “four”)
that happen all at once:
This is what you can do: When it comes to
eating and exercise, we all have room for
improvement. With a few small changes, you can
make your heart a lot healthier.
SATURATED FAT: There are good fats and bad
fats. Most saturated fats are bad. This type of fat
rolls around in your bloodstream without
dissolving. It settles on the walls of your arteries
and eventually blocks the flow of blood throughout
your body, making your heart work harder.
13
a day! That means that each week, one whole day
and night goes to nothing but television. You could
enjoy a lot of other things in that time instead. Try
some exercise. Walk with a friend, shoot some
hoops, bike to a friend’s house, try a new sport, or
turn on the music and dance! It feels good because
your body needs to be active.
What to do: Make some changes. Try reduced fat
or skim milk instead of whole milk. The taste will
grow on you. The same goes for ice cream. Try
low- or no-fat frozen yogurt or ice cream; light
mayonnaise instead of regular; pretzels instead of
potato chips; salsa instead of a creamy dip; grilled
chicken instead of a burger; and sliced turkey
instead of bologna.
It’s great for your head and your heart.
Skip the vending machine snacks and try yogurt or
a piece of fruit. And remember, French fries are not
the only vegetable!
There’s a quick and easy quiz that the Center for
Science in the Public Interest has on its website
called the Rate Your Diet Quiz. It’s located at:
www.cspinet.org/quiz. Two other sites loaded with
information are:
SUGAR: Guess how many teaspoons of sugar the
average American consumes in a day. Try 21. The
average teenage boy eats 34. The recommended
daily allowance of sugar is just 10 teaspoons. Most
processed foods have sugar added to them. For
example, a 12-ounce cola contains more than 10
teaspoons of sugar. What’s the problem?
www.mayoclinic.com, and the Department of
Agriculture’s food and nutrition information center
at www.nalusda.gov. Click on FNIC.
The People Side of Science and Medicine
Sugar is empty calories, with no nutritional value.
Consumed on a regular basis, it can cause weight
gain, and too much weight gain can lead to heart
disease (or obesity, or diabetes). Cut back while you
can.
The Partners of the Heart story shows that who
we are affects our approach to science and
medicine. Usually, scientists and medical
researchers are dedicated to testing their ideas and
experiments, but their values can in subtle ways
affect how they do research, and how their results
get to the public. This fact is obvious to groups that
feel slighted. The life stories of Henry Wall and
Rodney Hood (pages 24 and 25) show again how
race can affect medicine.
What To Do: Start with breakfast. Check the label
on your cereal box. If it has more than 8 grams of
sugar per serving, try a different brand and add a
banana or strawberries for the sweetness. Instead of
a soda, try water, seltzer, orange juice or low-fat
milk.
Drs. Bevin Engelward and Maria Terésa TarragóTrani challenged a different bias ― the notion that
women are less able to conduct science than men.
People like Engelward and Tarragó-Trani are
helping to prove that notion wrong, but people’s
biases are often slow to change.
You’ve heard it before: Our bodies are two-thirds
water. The next time you feel hungry, you might
just be dehydrated. Try drinking more water
throughout the day.
TELEVISION: According to one study, the
average American watches FOUR hours of the box
14
In His Own Words: A Cardiac
Surgeon Reflects on Heart Surgery
and the First Blue Baby Operation
Dr. William Stoney is a heart surgeon at the St.
Thomas Hospital in Nashville, Tennessee, where he
helped to establish a cardiac surgical service in
1967.
At the turn of the century,
most surgeons thought that the heart would never
be amenable to any kind of procedure, that just
touching the heart was a no-no.
There was a surgeon named Alexis Carrel. He had
worked — in the period 1910 to 1915, prior to the
First World War — on developing a number of
vascular procedures in the experimental lab. But
they never carried over into the clinical world. It
was all there in the literature. He even received the
Nobel Prize for his work.
So when Dr. Blalock started doing vascular
surgery, there really wasn’t any, in his training and
in his background, there wasn’t any experience to
fall back on. The vascular surgery that he did, he
sort of had to develop all over again. He had to
repeat what Alexis Carrel had already done and
learn how to do those procedures.
Several years ago I became interested in the history
of cardiac surgery, especially the oral history. Our
specialty did not really exist until the 1940s and
1950s and many of the pioneers of that time are still
alive. I was fortunate to receive a grant from the
Department of Cardiac Surgery at Vanderbilt to
visit some of these first-generation surgeons and
record their recollections on videotape for the
Medical Library at Vanderbilt. So far, I have
completed 32 interviews. All of them are very
interesting, I think, and some are inspirational.
They represent a time when everything in cardiac
surgery was new and exciting.
On Tetralogy of Fallot (Blue Baby Syndrome):
Tetralogy of Fallot was a complex congenital
abnormality of the heart. It was easily recognizable
in that children had unoxygenated blood circulating
that gave them — their skin and their eyes and their
nails — a bluish sort of tint. In Tetralogy of Fallot,
there’s not enough blood going to the lungs. So they
were called blue babies.
On Early Experiments in Heart Surgery:
The heart functions like a pump, and without the
flow of blood, life can’t go on.
15
with this terrible problem, that there was a surgical
solution. And so people came, flocked, to Johns
Hopkins after the first operations were reported
back in 1945.
The blue baby operation was a sensational event.
There were a number of stories in the newspapers
about people who had come to Baltimore with their
little sick child. And the operation was successful.
Almost all of those died
before they reached teenage years, although an
occasional patient with Tetralogy may have
reached…his twenties.
But almost all of them died and many of them were
severely disabled. They were undernourished and
small. They would have fainting spells if they
exercised too much because of not enough oxygen
to the brain. They would sometimes have seizures.
So their prognosis was very grim.
I don’t think anybody thought that there was, right
on the horizon, anything that could be done. There
were so many unknowns.
…People came from Europe at the end of the
Second World War. From my viewpoint, it was the
very beginning. …The blue baby operation was the
beginning of cardiac surgery. Before that time, I
don’t think there was any real understanding or
thought of it.
The first patient that Dr. Blalock operated on, a
little girl named Eileen Saxon, would pass out while
she was eating, come out of her oxygen tent, and
she was so sick that even when she would cry
sometimes she would have a seizure and pass out.
On A Total Correction of the Blue Baby
Syndrome:
It was 10 years or more before a total correction of
Tetralogy of Fallot was possible. This was a
stopgap procedure, but it was highly successful.
Many of these patients lived almost normal life
expectancy.
On the Instruments Used:
I think it would be very primitive to compare
today’s vascular surgery to vascular surgery in the
thirties. The instruments and the materials then
were very primitive.
The instruments that weren’t available in the
1930s…[are those that] clamp and control bleeding
of large blood vessels without injuring the blood
vessels, and suture materials that allow the surgeon
to sew vessels together. They were totally
unavailable.
There were a few doctors at that time who were still
working and thinking in terms of a heart-lung
machine, so that some day total correction of
congenital heart disease would be possible. But
they were very few. It was certainly just a small
number of people in the 1940s working on that
problem.
On the Aftermath of the Successful Blue
Baby Operation:
With the first three successful patients and with the
first scientific paper about them, everybody
suddenly, not just medical people but lay people,
realized that children with Tetralogy of Fallot and
16
Seven-year-old James Nix, Jr., of Washington,
D.C., underwent the same surgery by
recommendation of Dr. Roland B. Scott of
Washington’s Freedman’s Hospital in 1946. Dr.
Scott was the chief of pediatric services at
Freedman’s Hospital and he recognized that little
James had enough of the symptoms of typical blue
babies that he, too, could benefit from the surgery.
The First African American Blue Babies:
Clarence Durham of Baltimore was the first African
American child to receive the Blalock-Taussig
surgery for blue babies in 1945, within a year after
the inaugural operation was performed. Sadly, the
four-year-old did not survive after the procedure.
Photo from Partners of the Heart reenactment scene of first blue baby operation in 1944
17
Try your hand at conducting a virtual surgery
at the Partners of the Heart website,
www.pbs.org/wgbh/amex/partners/
Click on “You Be the Surgeon” in the
Breakthroughs section of the site.
18
In Their Own Words: Blue
Babies
me alone. Let me get my breath. I’ll be fine,
don’t worry.” I was reassuring them. It’s hard
to be a purple kid and not be embarrassed. I
mean, there aren’t that many purple kids
running around…. I knew I was purple. I
couldn’t help but see it. My hands were purple,
my nails were purple, my toes were purple, my
nose when I looked in the mirror was purple…I
was purple from head to toe.
Sandra Stoltz
I no longer began to think of myself as a kid
with a heart defect. I began to think of myself as
a kid who was defective. And it took a long time
to get over that.
On May 17, 1945, newspapers announced the
success of the first three Blalock-Taussig
Shunts. Almost immediately, sick children
began to pour into Johns Hopkins. Sandra Stoltz
was one of the first 50 children admitted and in
October 1945 Dr. Blalock performed the
procedure on her. Though she was very young
when she came to Johns Hopkins, Stoltz has
vivid memories of growing up as a blue child
(or purple, as she liked to say) and of Blalock,
Taussig and Thomas. She is now a prominent
psychologist in Sedona, Arizona.
In October 1945 I came to Johns Hopkins for
the surgery. My parents told me I had a 50-50
chance, and I said, “There’s no doubt about it.
I’m gonna be in the 50 that make it….” I wanted
it so desperately. In fact, my worst fear was that
after all the examinations and tests they were
going to run, they would find out that I wasn’t
eligible. That was my worst fear, not the
surgery. In fact, I had a friend who wasn’t
eligible and she got to be 14 and then she was
blue and then she died.
I think the idea that I was different from other
children began to dawn on me when I was about
three and I couldn’t keep up with the others, the
neighbor’s kids, running around getting into
trouble. I was more tired and I had to play
differently.
I met Dr. Taussig when we came to Hopkins to
be evaluated for the surgery. … She struck me
as a very kindly, soft-spoken lady and I liked
how she talked to me. She didn’t talk down to
me. … I remember her being very reassuring
and her calm, quiet voice was very soothing.
For instance, we’d be walking just one block to
get ice cream or something and I’d have to
squat in the middle of it because I was simply
too tired to go on. And that embarrassed me.
The other kids had to stand around and wait for
me and I felt really weird.
[Blalock] was more remote; he was like God.
The big surgeon. He was a very handsome man
and he seemed big to me. I don’t know whether
he actually was or not. But I liked him. I really
liked him. I remember Vivien Thomas as this
very kindly, gentle, soothing man. I don’t know
what exactly he did to me; I think it was some
sort of angiogram. He described the procedure
step by step. He told me exactly what to expect
and he made it unscary. He really did. He
created a profound impact and of course, as an
adult psychologist, I know he was way ahead of
his time in terms of how to prepare children for
something like this.
I remember I was playing with the kids in the
yard that was in back of ours and I passed out.
And I woke up and there was this ring of adults
around me, including one of the mothers who
was a nurse, and they were all saying, “What’s
wrong? What’s wrong? What should we do?
What should we do?” And it’s like I was old
before my time, and I was saying, “Just leave
19
May Pole Dance, but I couldn’t. It was just too long
and you had to go up and down and up and down
Joleen Reynolds
with the streamers on the May Pole, and I just
couldn’t do that. I was real disappointed. I was
always wanting to do things I couldn’t do.
I was nine years old when I found out there was a
surgery that they could do that would help me. They
put me through a cauterization and it was a really
painful cauterization that they don’t do anymore. I
[lay] on a big black table and they had to shock me.
And they told me that if I would be very still for the
first shock and the second one that they wouldn’t
have to do it again. So I was very good, but this was
a very painful ordeal. After that, they said, “Yes,
you’re a candidate for the surgery.”… So, a year
later, on June 20th, 1951, I went in to have my
operation. Dr. Jay Duncan from Dallas performed
it. At that time, he was the only doctor in the
Southwest…who did that surgery.
After the first blue baby operation, news of the new
surgery spread like wildfire. Doctors from around
the world came to Johns Hopkins to watch Dr.
Blalock perform the procedure. One such doctor
was a surgeon from Dallas, Dr. Jay Duncan, who
then returned to Texas to operate on children on his
own. On June 1951 he operated on Joleen
Reynolds, a spunky 10-year-old constantly trying to
challenge her disability. Now she is an active
community leader in Houston.
[Afterwards], I was able to ski; well, at least I tried
to ski. I cried all the way down Bunny Hill because
I was scared. I didn’t have good balance, but I tried
everything I could — that I thought that I could do.
I did tennis, things that I could never have done as
a child.
My first memory was going to lots of doctors and
my parents trying to find out why I fainted. … They
said there was nothing they could do for me at first.
They took me home and said you’ll have to wait, but
my parents said, well, some day there will be an
operation that will help me be normal.
[Even after the surgery], I always thought I would
not live beyond 40 or 50 simply because my heart
had been defected and worked so hard. I would ask
doctors and they would say, “Well, [we don’t
know].” That was when I realized that there wasn’t
anybody ahead of me for them to tell me. Finally,
one day I asked my doctor how long I would live
and he said, “Joleen, stop worrying about it. You
could live to be 80.” “Eighty? I don’t have enough
money to live to be 80.” So then I went home and
started planning my future because I never really
thought that I would live long enough to maybe
retire and have a future. Now I do.
I always wanted to do more than I could do, and I
was always challenging myself. In the first grade,
we had a big May Pole festival and I wanted to do
all the dances. I did the Indian Dance. I did the
Himerbering Dance, and I tried real hard to do the
20
Margaret Belkov
I used to play dodgeball and, when I got tired, I got
hit by the ball….So I tried to do a lot of things, and
I could only do them at certain points….I learned to
ride my sister’s bike, which was too big for me. But
I did it. I rode it. I had a hard time of it. When Mom
told the doctor, he almost had a fit. He said,
“You’ve got to be kidding.” He was shocked. But I
wanted to do it and I did it. When I got out of
breath, I just stopped for a while.
Sometimes I pushed it right to the edge, but I always
did what I wanted….I’d get very out of breath. I’d
really have trouble breathing.
One of the more successful blue baby operations
occurred in August 1947, when Dr. Blalock
operated on Margaret Belkov — affectionately
called “Cookie” by her friends and family. So
successful was the operation that when Blalock had
to testify at the vivisection hearings in Washington,
D.C., in 1949, he asked Cookie to accompany him.
Blalock had Cookie and two other blue babies
describe their lives before and after the operation to
show the benefits of animal testing. Margaret
“Cookie” Belkov now lives in San Francisco.
I did want to be more like the other kids. I wish I
could have kept up with them. I was the kid who
went to the dance and no one would dance with me,
and I knew why.
I used to wonder, though, what it would be like to
not be sick…then I’d be able to keep up with my
sister. She was the very athletic one and I couldn’t
do that….There were things I wish I could have
done and there were times that I thought that if it
wasn’t for my heart, I’d be a lot like [my sister].
I got used to knowing what I could do and couldn’t
do.…In recess we’d play ― I don’t remember the
name of the game ― we’d get in a circle and
somebody touches you on the shoulder and you
have to chase that person. [When someone would
tag me], the teacher would say, “Now, don’t run,
Margaret.” And I just thought, “This is so stupid.
I’ve got to run.” I think I really resented her for
saying that.
[After the surgery], I could do everything. I would
do things and then all the sudden it would hit me
that I should be out of breath. And I wasn’t. I mean,
it was really a second-life story….I was walking
with my sister one day…and I was keeping up with
her. I wasn’t getting out of breath. And that was
neat. That was great. I finally did something I really
wanted to do. I kept up with her. I could walk with
her.
21
Edward Mansell
It was a miserable childhood. You couldn’t do what
the other boys and girls were doing.
A large proportion of blue babies squatted. The
reason [you] did it was because [you] got out of
breath. And you had to sit down, and if there wasn’t
a chair or wall or anywhere to sit down, then it was
easier to be in the squatting position. And you just
did it the moment you got out of breath, regardless
of where you were.
I remember talking to my elderly aunt…and she
would say that I would be standing there one minute
and the next minute I would be squatting. She said
this was commonplace the whole time. By the very
fact that you were sort of out of eye-line with
everyone else, it was a form of exclusion.
In 1947 Blalock embarked on a tour of Europe,
teaching and performing the operation in numerous
hospitals across the continent. The news of the new
operation was so electrifying that wherever Blalock
traveled, he was lauded and treated like royalty. In
Guy’s Hospital in London, Dr. Blalock performed
his 301st operation on 13-year-old Edward Mansell.
Mansell is now the oldest surviving blue baby, a
father and a grandfather, and an active fundraiser
for heart diseases at Guy’s Hospital.
I remember Dr. Blalock came around, and
whenever he came around, he was accompanied by
these seemingly hundreds and hundreds of people
just standing around, just wanting to be within
earshot of the man, wanting to hear what he had to
say.
One of the things about my childhood you have to
remember is that when I was five, a war broke out.
And for the next few years, we were traveling
around England trying to find a place to live. There
was at one time a suggestion that we should go to
America. I thought the Americans wouldn’t help me
because of my medical condition.…Eventually, we
landed at a little place called Letchworth in
Hartfordshire, which was known as the first Golden
City, and I was sent to a local school there.
We recovered very quickly after the operation.
Within three to four days, we were out of bed,
running around, and the amazing thing was that
now we could run around and didn’t get out of
breath. Most children spontaneously stopped
squatting and in fact the problem was trying to stop
us from doing too much….Trying to control a 13year-old, much less a six-year-old or three-yearold, was virtually impossible!
22
From Molecule to Marketplace:
Making Medicine
patients. The U.S. government’s Food and Drug
Administration must give its approval to all new
medicines before they can be made available to
patients, which takes time, too.
When we go to the drugstore to buy aspirin or to get
a prescription filled after seeing the doctor, we
usually don’t stop to think about how that medicine
got there. We take for granted that there are many
medicines available to help us feel better. But it
wasn’t always that way.
Right now, more than 1,000 new medicines are in
the development stage at U.S. pharmaceutical
companies. Many of these medicines are aimed at
treating various forms of cancer; diseases often
associated with aging, like arthritis, diabetes and
depression; neurological disorders, such as
Alzheimer’s disease and multiple sclerosis; as well
as the leading killers — heart disease and stroke.
Even though it takes years for a drug to go from
molecule to marketplace, there is good reason to
feel hopeful that many of the medicines under
development today will help people in the not-toodistant future to live longer and feel better.
Did you know that when your grandparents were
little, there were no effective medicines to treat
pneumonia? Or that a vaccine for the crippling
disease polio became available only in the 1950s?
Or that small pox used to kill up to 4 million people
around the world each year? Or that at the
beginning of the 20th century, the average American
could expect to live to only age 45 or 50 instead of
75 or 80 today?
Vivien Thomas understood how critical researchers
are to advancing medicine. It’s one reason he took
so much care to properly train and mentor young
medical students who came through his laboratory.
Thomas also experienced the excitement and joy of
scientific discovery, knowing that what researchers
do in the laboratory can make an enormous
difference in people’s lives. Pharmaceutical
researcher Dr. Henry G. Wall feels that joy too. In
the pages ahead, you can read his story and those of
Drs. Rodney G. Hood, Bevin Engelward and Maria
Terésa Tarragó-Trani.
Researchers for pharmaceutical companies have
played a large role in treating disease, reducing
death and disability and improving the quality of
life for people afflicted with various illnesses. Many
of us don’t realize the risks and costs involved in
the quest to find medicines that relieve human
suffering. So let’s take a closer look at what goes
into getting a medicine to the marketplace.
The average time it takes for a single medicine to
go from being discovered in the laboratory to
appearing on the pharmacy shelves is 12-15 years.
And the cost? About $500,000. Researchers must
first discover the target for a potential medication to
address. For example, the target might be a
chemical to block the attachment of a virus to a
cell’s DNA. Once the target is identified, thousands
of compounds are screened to see if they act on the
target in the desired manner. If a good compound is
found, thousands of lengthy tests must be performed
to discover whether it is safe and effective for
23
graduation from college. Within two years, Wall
was sent to Vietnam. He served in the Army,
active duty, from June 1967-August 1971 and
began vet school at Tuskegee in September
1971. “I learned the lesson of persistence. I also
learned that one should not think that a good
opportunity is not for them,” says Wall, who faced
opposition in becoming the first African American
chosen for an Army veterinary education program.
Success Story: Henry G. Wall
Field: Veterinary Pathology
and Pharmaceutical Research
Focus: Now at the pharmaceutical company
GlaxoSmithKline (GSK), Wall is the head of
pathology in the safety assessment division in
North Carolina. He and his team of scientists study
how different medicines affect the body to make
sure they are as safe as possible for humans. Wall
says he enjoys helping in the discovery of new
medicines, knowing that those medicines will
benefit people. When people learn what he does
for a living, they will sometimes tell him about
how certain drugs have helped them. “Those are
the times when you know what you do is worth it.”
Beginnings: Henry Wall grew up in Florida with
six sisters and one brother. Two of his siblings have
the same father as Wall. When his parents divorced,
his mother and stepfather had five more girls.
Wall’s real father was blinded in an accident at a
citrus packing plant. Even though his mother and
stepfather worked, his family was very poor. “We
were all encouraged to work whenever we could to
supplement the family income,” Wall says. For an
agricultural project in high school, Wall and a
classmate teamed up to raise a bull calf, using their
lunch money to buy animal feed. When the calf ate
grass saturated with fertilizer, it was rushed to a
veterinarian. The calf died of poisoning—and
Wall’s interest in animal research was born.
Achievements: “Becoming a vet, that’s probably
what I would say is my greatest achievement, and
in so doing, having the persistence to get to that
goal.” Along the way, mentors encouraged him ―
teachers in elementary school, high school and
college, and senior officers in the Army, including
a white captain from Mississippi who “never
forgot his positive experiences with black people,”
says Wall. “What people saw in me was a desire to
achieve all of my potential. They saw I had a goal
and they also saw I would work hard.”
Then What?: Wall attended Florida A & M
University, majoring in animal science. He earned a
doctorate in veterinary medicine from Tuskegee
University in 1975. While in vet school, a summer
job at Walter Reed Army Institute of Research led
to his decision to pursue veterinary pathology. This
field deals with animal disease and how animals can
be useful in developing new medicines for people.
Wall helped find antidotes for toxic substances that
could be used against U.S. soldiers in a war.
Excitement: Mentoring young people is a passion
these days for Dr. Wall, who regularly returns to
Florida A & M and Tuskegee to talk to students.
He also mentors student interns at GSK. One of the
reasons Wall believes he attracted mentors in his
youth is that he paid attention to their constructive
criticism. “They saw by my actions that I listened.
I think that motivates a mentor to give more. The
more you respond, the more interested in you as an
individual a mentor becomes.”
Obstacles Faced: Even though he received some
small scholarships and had a part-time job in
college, money was always a problem. One of the
turning points in Wall’s life was when he joined the
ROTC (Reserve Officers’ Training Corps) so that
he could get a full-tuition scholarship. In return,
Wall had to spend four years in the Army upon
24
Success Story: Rodney G. Hood
Another obstacle was bad advice. One guidance
counselor discouraged him from professional
dreams. He said Hood should lower his
expectations and learn a trade instead. Many
talented African Americans got similar bad advice.
“Surround yourself with people who will give you
realistic advice that’s in your best interest,” Hood
urges. “Be sure to get advice from multiple people
before you make a decision. Your decision about
what to do with your life should be based on your
passion. Trust the advice of people who know you
best, and PERSEVERE.”
Field: Internal Medicine
Beginnings: Rodney Hood grew up in the Roxbury
neighborhood of Boston, the eighth of nine
children. His father was a shipyard mechanic and
his mother, with no high school degree, “had a
Ph.D. in common sense,” Hood says. She
emphasized the importance of education. Hood
graduated from Boston Technical High School,
where he led the track team. An older friend
decided to do pharmacy studies, so Hood
considered it too. He did well in sciences, math and
chemistry, and was leaning toward a career in
engineering.
Health statistics show inequalities in health care and
people’s access to it. African American and
Hispanic doctors tend to have more problems
getting their patients admitted to hospitals than
white physicians, according to a 1998-99 survey.
“America is infected with the disease called
racism,” Hood says. “It’s institutionalized and it
happens in ways that are very subtle.”
Focus: “I am a general internist who practices
medicine in a low-income area in San Diego and I
love it,” says Hood, age 56. He opened his medical
practice in 1976 in an urban community that is
about half Hispanic and half African American.
There was a huge demand for physicians, especially
in primary care. His practice grew quickly.
Then What?: After high school Hood accepted a
track scholarship to Northeastern University in
Boston. An injury in his first year ended his track
dreams and put his college education at risk. But he
got an academic scholarship and pursued pharmacy
studies. He graduated second in his class. While in
graduate school in Pharmacology-Toxicology at the
University of California-San Francisco, he took
classes at the medical school and decided to apply
to medical school at the University of CaliforniaSan Diego. He was one of the first African
Americans to graduate there.
Achievements: Dr. Hood became involved in
administration, founding the CompCare Health Plan
and the Multicultural IPA. He also got into medical
activism, both with the American Medical
Association and the National Medical Association
(a large professional organization formed in 1895
by African American physicians who were denied
entry to the AMA). Hood became the 101st NMA
president for the 2000-2001 term.
Obstacles Faced: Hood grew up in a rough
neighborhood with lots of distractions. Many of his
peers quit school. Others went to prison. He kept his
focus with the help of his family and heavy
involvement in extracurricular activities like track
and field. He found that his friends respected his
choice to focus on achievement and shielded him
from getting into trouble.
Excitement: “Stimulating people to take
responsibility for their own health is exciting,”
Hood says. He also enjoys talking with audiences
and drawing attention to the medical disparities in
the United States.
25
Success Story: Bevin Engelward
Another obstacle was a common attitude against
women in science. “Something in our culture makes
it possible for women to be taken less seriously than
men,” she says. “A woman managing a lab
sometimes has to work extra hard to get others to
take her requests seriously. Women have to
counteract the bias by becoming particularly good
managers. That means being very clear about what
she expects from the staff.” Engelward, 35, says
that with any career, managing a family can be
complicated. Because women have traditionally
shouldered most family responsibilities, men
occupied most positions in the upper levels of
science. As men have become more supportive of
women and their careers, that has begun to change.
Field: Genetic Research and Public
Health
Focus: She manages a research lab that aims to find
the causes of genetic mutations that lead to cancer.
“Recombo Mouse” is helping to show the process
of genetic change. Dr. Engelward’s lab altered the
genetic make-up of Recombo Mouse so that a
movement in the mouse’s genetic sequence makes
the affected cell turn bright fluorescent.
Beginnings: Bevin Engelward grew up in Stony
Creek, Connecticut, “an old-fashioned town where
it was assumed that girls couldn’t do math, or drive
well, and that science was mainly for boys.” Her
father was a university professor in biophysics.
From lobstering and other outdoor activities, she
became fascinated with living things and biology.
Achievements: Before pursuing graduate school,
Dr. Engelward worked for two years in a
microscopy lab and at a computer software
company. When she went on to the Harvard
University School of Public Health, she knew that
she wanted to study biology. At the Massachusetts
Institute of Technology her achievement was
recognized in a rare gesture — she was asked to
apply for a faculty position before she had even
finished her doctoral degree.
Then What?: At an early age she thought she
might become a physician, but the schoolwork was
daunting. “The most important thing is to believe
that you can succeed and to really want to do it.”
Engelward enjoyed athletics and rowed on the crew
team. At Yale University, she received a bachelor’s
degree in history. She loved her advanced science
classes, but she thought only “geniuses” could be
scientists and worried that she was not good
enough.
Her greatest satisfaction is in making a difference in
a student’s life. She enjoys mentoring students and
watching their careers develop.
Obstacles Faced: The common belief that you have
to be a star student to be a good scientist, or that
you have to have great natural talent in math to be
successful. Good study skills helped her past those
misconceptions. “Math is essentially a language,”
Dr. Engelward says. “Anyone can improve at a
language through practice.”
Excitement: The opportunity to be creative in the
lab, “to innovate things that nobody else has ever
done before — the thrill of ground-breaking work.”
26
can demonstrate that you’re a decent person, a good
scientist.”
Success Story: Maria Terésa TarragóTrani
Focus: Dr. Tarragó-Trani’s research is focused on
the chemical composition of cancer cells. In other
words, she uses chemistry to help find cancerous
cells and treat them. Her current study involves
using a protein that specifically recognizes certain
cancer cells (ovarian cancer and leukemia) to detect
and treat those cancers. That protein is the shiga
like-toxin B fragment (SLTB). The SLTB protein
fragment binds to particular cancerous cells, it
produces a chemical reaction, “like a lock-and-key
interaction.” The SLTB protein fragment is also
linked to a photosynthesizer, a molecule that, when
excited by light with a certain wave-length,
produces a reaction that kills cancer cells. “It’s a
really interesting combination of chemistry and
biology.”
Field: Biochemistry Research
Beginnings: Maria Tarragó-Trani grew up in the
city of Santo Domingo, in the Dominican Republic,
one of four children. “My parents were loving but
strict,” she recalls. She finished high-school studies
at the Instituto Veritas, where a science teacher
inspired her. “The way she taught science made it
exciting,” Tarragó-Trani says.
Achievements: In 2001 Tarragó-Trani and her
supervisor, Dr. Storrie, submitted a patent
application and hope to interest other biomedical
groups in using the process they have developed.
Then What?: She got a bachelor’s degree in
chemistry at the Universidad Nacional Pedro
Henriquez Urena, in Santo Domingo, and pursued
graduate school in the United States. “I decided I
wanted to apply whatever I learned to something
living, to living processes ― so I chose
biochemistry.”
“It’s very satisfying to get projects to completion,”
she says, whether it’s her Ph.D. degree or a research
paper to be submitted for publication in a scientific
journal. “The feeling that part of it is done is very
good.”
After getting her Ph.D. degree, she had two
children, now 10 and seven years old. While they
were small she left research and worked part-time
in a related field. In 2000 she resumed research
with a project in the laboratory of Dr. Brian Storrie
at Virginia Tech, funded by Carilion Biomedical
Institute.
Excitement: “Research can be very frustrating. It
takes time. So when you have a breakthrough, it’s a
really exciting moment.” One such moment came in
her current experiments, where they tested the idea
that the SLTB protein fragment enhanced the effect
of the photosynthesizer in killing cancer cells
(compared with the photosynthesizer alone). After
days of work, they saw that the hypothesis was
correct. Fluorescent chemical dyes made the living
and dead cells look different from each other under
a microscope. The nucleus of a dead cell would
glow red. The living cells glowed green.
Obstacles Faced: “Number one, my own
insecurities. Second, being a woman in a field
dominated by men ― especially being a foreigner
and a Latina. You have to work harder to be taken
seriously.” In graduate school, for example, male
students were sometimes considered to know more.
She had to invest more effort to be recognized.
“The most important ingredient is to like what you
do. You have to remind yourself: What is your
goal? Focus on that goal. It can be tough if you
don’t have encouraging feedback, but remember
your goal.”
“I like working hard, and I’m true to myself,” says
Tarragó-Trani. “Perhaps my best ally has been time.
Over time, working with integrity and honesty, you
27
4. For the Classroom
find "the gateway to the North" segregated and
quite keen on confining African Americans to a
lower socioeconomic position in American society.
This section looks at the historical background of
the partnership of Vivien Thomas and Alfred
Blalock. First, Bobby Lovett, a historian of African
American history at Tennessee State University,
describes the differences in how segregation was
practiced in Nashville and Baltimore. Then Nathan
Crippens, a retired school principal, gives a firsthand recollection of how segregation directly
affected his life in the 1920s through 1950s. Last,
John Egerton, an independent writer on Southern
history, describes two people who spoke out against
segregation during the 1930s and 1940s. Have
students reflect on these readings and discuss how
the experience of segregation affected people on a
day-to-day basis.
Nashville, like most southern cities, was segregated
more by post-Emancipation practices and coercion
than by law. Tennessee’s Jim Crow law of 1867
kept local schools segregated until 1957. Through
most of Nashville’s history, blacks and whites often
lived in the same neighborhoods — often on
alternating streets, but not segregated by residential
codes. Near Vanderbilt University, where [Thomas
and Blalock] worked, the neighborhood of 8th
Avenue to 15th Avenue was home to middle- and
working-class black families; from 16th Avenue to
21st Avenue was home to whites only, just because
it had always been that way. In downtown
Nashville, signs for “colored” and “white” kept
restrooms, restaurants, hotels and streetcars
segregated until 1960, when student sit-in
demonstrations forced changes.
Two Kinds of Segregation
Dr. Bobby L. Lovett
In Baltimore, Thomas and his family saw another
side of Jim Crow segregation. Like nearby northern
cities, Baltimore had inner-city ghettoes demarcated
by law. Maryland was a former slave state, and its
rules of Jim Crow warned travelers from the North
what to expect further south. One of the first
successful lawsuits to force the racial integration of
an all-white graduate school was brought to court in
Maryland in 1936. That case set a precedent for
similar NAACP suits to follow throughout the
South. The NAACP lawyer who argued that case in
court was Thurgood Marshall, who was born and
raised in segregated Baltimore and who later
became the first African American justice on the
U.S. Supreme Court.
Professor of History, Tennessee State University,
Nashville, and author of The African-American
History of Nashville, Tennessee, 1780-1930: Elites
and Dilemmas.
Partners of the Heart tells the story of two
medical scientists who got their start in Nashville,
and who completed their mature work in Baltimore.
The film shows the peculiar nature of Jim Crow
society in the first half of the 20th century and the
costly limitations of that society’s Old South rules,
practices and racial attitudes. These two men — one
African American, one European American — lived
and worked in a society that kept constraints on
African American citizens long after the U.S.
Supreme Court declared in Brown v. Board of
Education (1954) that racial segregation was
harmful and unconstitutional. In Baltimore, too,
Vivien Thomas and his family were disappointed to
Baltimore relied on laws and zoning ordinances to
enforce neighborhood segregation. The Maryland
judiciary upheld restrictive housing covenants as
late as 1938. The Supreme Court declared all such
devices unconstitutional in 1948. Still, segregation
of suburban housing remained a barrier for
Baltimore’s black working class, as historian
Harold A. McDougall has noted (Black Baltimore:
A New Theory of Community, 1993). Public schools
in Baltimore were desegregated six years after
Nashville began to desegregate its schools. In 1964,
28
You knew that, objectively, you didn’t have to do
something wrong to have a problem. You only
needed somebody to perceive that you had done
something wrong. Many people suspected that if a
youngster did something [against Jim Crow laws],
then he would be punished for it [by whites], even
though he hadn’t really done anything wrong. This
awareness made each family set the limits of what
they would stand for.
the comprehensive Civil Rights Act was passed,
which allowed African Americans to sue for
damages in federal courts for violations against
their rights. Only then did Johns Hopkins and other
Baltimore institutions finally agree to desegregate
fully.
In the wake of Rev. Martin Luther King, Jr.’s
assassination in 1968, riots and the Black Panthers
shook up Baltimore. The city experienced yet
another form of de facto segregation when many
more whites fled to the suburbs. By 1978, just
before Thomas retired, so many whites had left the
city that two-thirds of the children in the city’s
schools were classified as black.
I had an experience with my little three-year-old
boy, my oldest son, my pride and joy. And I was in a
little town where I was the principal of the only
black high school in the county. That sort of gave
me an elevated niche to cocoon me from the worst
effects of segregation. But I was shocked one day
when I was brought face to face with a situation
that could have been explosive, but would not be
recognized that way today.
Still, in the era of Jim Crow segregation, Vivien
Thomas and Alfred Blalock formed an incredible
American team of medical research and surgical
skill that made incalculable contributions to
medicine in the United States and internationally.
Thomas went from Jim Crow Nashville to Jim
Crow Baltimore, and on to limited success. Blalock
went from success to greater success,
unencumbered by racial limitations. This film gives
the viewer a real story of the contradictions of that
peculiar institution called Jim Crow, and the human
and inhuman effects of racial discrimination in
American society.
One Saturday morning I stopped by the drug store
that sold bus tickets, accompanied by my threeyear-old son. We were going to the next town. My
son knew the store as the place to get ice cream —
it was the only ice cream place in town that served
blacks. While I was buying our bus tickets, there
was a little white girl his age who had just bought
an ice cream cone and she was eating it. And he
walked over to her and said, “Give me some.”
And she held hers out to him and he took a bite
from it. That’s not a crime, now. But that was a real
crime in that little Southern town at the time it
happened.
In His own Words: When an IceCream Cone Isn’t Just an IceCream Cone
Every kind of thought raced through my mind.
Whatever happened, I thought, nobody was going to
hit my boy. And I just tensed up to protect my
family’s integrity. Surprisingly, the mother smiled
and said to her little girl, “You are very generous,”
and didn’t say anything else. Then the store owner
smiled. And I relaxed.
But at that split second, I was prepared to fight…
That’s how deeply embedded that kind of thing was
in the South at that time…If that mother had
reached over and smacked my child, I don’t know
what I would have done. Or if the store owner had
instead come around the counter and attacked me
— and sometimes that happened — I would have
forgotten my job, forgotten everything else.
Nat Crippens was a school principal in the South
during the 1940s. Like other African Americans
then, he navigated the strange rules of segregation.
This is his account of an afternoon’s encounter that
nearly triggered an explosive situation.
29
protect that boy at all costs. About 50 of the men
then went next door to protect the teenager from
being arrested.
What would you do? Put yourself in Nat Crippens’
shoes in the 1940s. What would you say if the
woman complained about your son eating from the
same cone as her daughter? How would you handle
the situation?
In front of a nearby church there was a vacant lot.
By the time it got dark, at least 600 or 800 young
white men were milling around in that lot, cursing,
yelling, and intimidating the whole African
American community. The children were scared.
In His Own Words: When a
Neighborhood Drew the Line
Around nine o’clock, the authorities drove up and
knocked on the boy’s door. When it opened, he was
surprised to find the house full. But he said, “Boys,
you know what I’m here for. I’ve got to get that boy
and put him in jail, to make sure the wrong kind of
people don’t get their hands on him.”
Nat Crippens grew up in eastern Tennessee and
southeastern Kentucky in the 1920s. Like other
African Americans, he learned early to navigate the
strange world of racial segregation. This is his
account of what happened one afternoon when he
was seven years old — and its life-and-death
consequences.
My father, as leader of the group, said, “Officer, we
know what will happen if the boy goes with you.
We’ve prayed about this and we can’t let it
happen.”
When I was seven years old, in 1921, a great many
race riots and lynchings were happening in the
South. One afternoon the African American boy
who lived next door became the focus — he was 17,
a handsome boy, and had been working in the home
of a white family for five years. He and the family’s
daughter formed a closer relationship than they
probably should have. The father came home from
work unexpectedly and as he came up the steps, he
heard the boy running down the back steps. The
man realized that the boy and his daughter had
been alone together in her room. That was the
biggest taboo of the time.
The officer got mad and turned red in the face.
“Now boys, it’s better for one black boy to die than
for the whole community to be destroyed, isn’t it?
The people in that field are in an ugly mood. If I
don’t bring this boy to jail, they may come up here
and burn this whole block to the ground.”
My father told him, “We know there are enough
people out there to come and take this young man.
There are only 50 or so of us here. They have
enough to take him, but you go tell them that the
first 50 that come will be lying there in the street
when the sun rises tomorrow morning.”
That afternoon, word got around that this boy
would be lynched. According to the rumor, either a
policeman or sheriff was going to drive to the boy’s
home and arrest him. The police car would get
about a block away, and then a white mob would
pull him from the car, drag him to a lamppost
where he would be lynched and his body riddled
with bullets. This would all be arranged. That was
a threat for the whole African American community.
The officer left and went to the men in the field and
when he relayed the message, the mob got loud,
yelling and shooting and using the n-word. My
mother kept my older brother and me away from the
window. The shooting and cursing went on for an
hour or so. We assumed they were surrounding the
block, getting ready to attack. My father was next
door, but before he had left he had given my
brother, who was nine, and me each a pistol, in
case the white mob came in the door. With
trembling hands we took the pistols. It is hard to
imagine a greater terror than we experienced that
night. But they didn’t attack. About midnight or 1
a.m., the cars had all gone.
My father was a preacher and one of the leaders in
the community. In our little shotgun house, about 15
feet from the boy’s house, leaders of the black
community came and went all afternoon, conferring
with my father. Late in the afternoon, the house
filled up with people for a prayer meeting. And at
the end of it the group vowed to each other to
30
When my father returned, we all hugged and cried,
we were so happy. It took an hour or more to calm
down from our rejoicing.
and you’re not gonna like it.” One week he was
talking to white people, and the next week he was
talking to black people. He attacked the very system
that was imposed by whites and tolerated by most
blacks. He took everybody on. Some called
McCray’s newspaper a “political bible” for the
state’s African American voters.
The next day, about midmorning, the area judge
came up to our house and knocked on the door. The
judge knew my father, and he sort of laughed and
said, “I hear you boys had a lot of fun here last
night.” But he knew it was no laughing matter. He
then said he and the other authorities had known
the threat was coming. “We could have stopped it
and we should have.” He tried to reassure us, and
told us it would never happen again. And it didn’t.
In 1944 McCray along with several others launched
the South Carolina Progressive Democratic Party.
In that election year, they saw it as a force to open
the state’s political process to black participation.
McCray was the party’s first chairman. He was also
dedicated to the NAACP and helped it to enroll
more members in South Carolina than in any other
southern state.
That was in Johnson City, about 250 miles east of
Nashville. The incident did not appear in the
newspapers. No one knew about it except the people
involved.
In 1950 McCray was jailed for his bold positions.
When he was released several months later, he
immediately resumed his protests against the
system.
What would you do? Put yourself in the place of
Nat Crippens’ father. What would you be willing to
risk to protect someone from a lynch mob? How
would you limit the risk?
As a series of court cases led toward Brown v.
Board of Education, McCray wrote in one editorial,
“In the America for which we labor, fight and die
today, there are no Negro, no white, no racial
children. They are all just children, and any teacher
not prepared to teach all of them isn’t prepared to
teach any of them.”
Two Early Activists for Civil Rights
On the white side of the divide, you had Aubrey
Williams. He grew up poor in a blacksmith’s
family outside Birmingham, Alabama. Never went
to high school. Worked at odd jobs around
Birmingham in the 1920s and early ‘30s. Somehow,
without a high school diploma he managed to get
into college; [he] graduated, went to divinity school
and became a minister. In all these experiences,
Williams nurtured a burning commitment to people
in need.
John Egerton
In the segregated South before the Civil Rights
movement, a few brave individuals, black and
white, challenged the prevailing culture of racism.
Here are two of their stories that are featured in
historian John Egerton’s book Speak Now Against
the Day: The Generation Before the Civil Rights
Movement in the South (1999).
Williams’ social work came to the attention of the
Roosevelts after Franklin Roosevelt became
President in 1933. This drawling white guy from
Alabama became, surprisingly, a favorite of Eleanor
Roosevelt. She made sure that he got a job in her
husband’s Administration. He advanced through the
federal government.
John Henry McCray was a black newspaper
publisher in Columbia, South Carolina. His weekly
paper was the Lighthouse & Informer, and every
week starting in the 1940s, this young man was
printing stories and writing editorials that said,
“Wake up, people. Something’s gonna happen here
Williams became a voice for social change in the
South. The region’s white congressmen considered
him a threat to their way of life, but it was
31
Williams’ roots in Alabama and the suffering he
saw in the South that made him champion racial
equality. It was an unpopular position.
Egerton says, “Reading these stories, and seeing
that there were such people of conviction — people
who had the courage to move against the tide in
order to move society forward — ought to inspire
us to realize that in our own time, there are things
that we need to speak out about. There are other
inequities in society. We have not come to the end
of this road, by a long shot.”
In January 1945, Roosevelt nominated Williams to
be head of the Rural Electrification Administration,
a position that required Senate confirmation. At the
Senate hearing, white southern Senators accused
him of being a Communist and misusing public
funds.
Discuss the problems that John Henry McCray and
Aubrey Williams faced. What did each of them see
as the solutions? What historical factors made their
struggle different from the struggle faced by the
Civil Rights Movement 20 years later? What might
have inspired them to take the positions they did,
and see different possibilities in the world?
Williams refuted those claims. And he asserted that
segregation had held back the South. He was denied
the job. Still, he continued to call for equality and
pressed the Democratic Party to take a stronger,
affirmative stand on Civil Rights.
32
Discussion Questions
Why not? What risks did that involve? In what other
ways did he challenge the system?
Medical Research:
•
What dangers did Vivien Thomas and Alfred Blalock
risk when they decided to operate on the human heart?
How did they keep these risks to a minimum?
•
How is the world that you live in similar to the
segregated world that Vivien Thomas lived in? How is
it different?
•
The blue baby surgical technique was considered a
radical procedure in its time. Consider the recent
developments on gene therapy, cloning and stem-cell
research. What makes these radical? How does the idea
of what is “radical” change through time?
•
How does social change happen — through public
protest or through private relationships?
•
Activities
Interview with a Family Member
For the blue baby procedure, Blalock and Thomas
conducted both the research (scientific discovery) and
the clinical application (they performed the operation
after it became a standard procedure). Which do you
think is more important — the discovery process or
how the discovery is applied?
Ask your parents, grandparents or other relatives
about a national figure (any kind — religious
leader, politician, musician, etc.) who affected their
lives in a personal way. Ask them what lesson they
drew from that person’s life for themselves, and
what message they would pass on to their children
or grandchildren. Then research that national figure
and the events that your relative described.
Society and Race Relations:
•
•
What are some key events in American racial history
from 1930 to 1964, the period of the Blalock-Thomas
partnership? What changes did each of those landmark
events signal?
Writing Exercise
Write a first-person narrative as if you were Vivien
Thomas. Write about the challenges that he faced
and what he thought of his achievements.
Vivien Thomas lived in a racially segregated society,
but he did not fight the Jim Crow system directly.
33
5. More Activities
Research:
Talk with your parents, neighbors and other adults
who have lived in your community a long time. You
might also talk to a grandparent or someone your
grandparents’ age.
The activities in this section are designed to help
students explore links within their community and
between communities. In the first one, identifying
local heroes helps to explore the idea at a personal
level, within a community. The second explores the
idea of an individual providing connection and
cross-cultural understanding between communities.
If you’re doing this as a group, you may want to
divide the tasks. One person can visit the library to
read about your community’s past, someone else
can visit long-time restaurants or stores and ask
about the people who work there or visit regularly.
You might write a letter to the editor at the local
newspaper asking for suggestions.
Finding Local Heroes
In making Partners of the Heart, we knew we
were telling the story of two highly intelligent but
very different men. As we peeled back the layers of
their lives and their characters, we came to see each
man as a hero in his own right. In putting together
this Viewer’s Guide, we found more heroes — they
are the success stories profiled in these pages.
When you have a list of candidates:
Discuss as a group who you would like to profile.
Consider what they have done, what they are doing,
and their impact on others.
When you have selected a hero:
What makes a hero? Honesty? Hard work?
Sacrifice? Resilience? Brilliance? Humility? Giving
of himself or herself to others? In today’s world of
sports stars and celebrities, it can be hard to
separate the hype from the heart. Who are the
heroes in your community? Or your school?
Confirm that your hero is willing to participate.
Then begin the more focused researching and
profiling process.
•
•
Maybe you question whether the idea of “hero” is
outdated, and wonder if labeling any person “a
hero” makes it harder to appreciate who they really
are. That’s fine. Don’t get hung up on the words.
The Heroes Project is designed to help discover
people you respect, people whom you would like to
be more like, but you may never have considered.
You might even create a web page about that
person; if so, consider posting it on the “Heroes
Project” section of the Partners of the Heart
website.
•
•
•
When you have all that, it’s time to put it all
together in a web page. Create a single web page
that combines a written bio, a timeline, some
photos, quotations, and more. Put all of the
elements in a zip file and e-mail it to the Partners
of the Heart web team with information about you,
your school and the making of the site. We plan to
post the sites and create links that let people view
them.
How to Begin: To figure out how to select a
person, decide on some criteria.
•
•
•
•
Interview your designated hero, his or her friends, coworkers, family members, neighbors and other
significant people in your hero’s life.
Create a timeline of the person’s life, marking
significant events that make him or her your hero.
Write a short biography of your hero.
Include quotes that represent this person’s philosophy
and outlook on life.
Get some photographs from the person to be included
on your web page.
Create a list of character traits that define a hero for
you.
List different types of heroic acts. What do they have
in common?
What historical figures do you consider to be heroes?
List the traits they have in common.
Discuss your ideas with classmates to come up with a
list of criteria you will use in searching for an unsung
hero.
Working with Different Communities: What
is “Cultural Competency”?
Cultural competency is a set of skills that increases
a person’s understanding of the differences between
different groups or communities. Cultural
background shapes our behavior and values.
Differences in culture therefore affect the way we
approach everything, including health care.
34
Physicians and nurses should realize, for example,
that each culture defines family ties differently.
Physicians who are culturally competent welcome
collaboration and cooperation for better health.
The following four success stories describe medical
professionals who are culturally competent.
Writing Activity
Choose one of the four stories on the following
pages and write about that person, describing the
difficulties you think he or she faced in dealing with
different cultures.
35
Twin Cities. As a family doctor in Minnesota’s
large Hmong community, she delivers health care in
ways that are culturally sensitive to her patients’
background. She bridges the gap between
traditional Hmong healing practices and modern
medicine. In health education, for example, she has
used Hmong story cloths. Hmong have long made
story cloths to translate their history into visual
form. The brightly colored scenes show how
Hmong were forced to flee Laos and live in refugee
camps in Thailand; they also tell folktales.
Traditionally, men drew the designs and women
embroidered them.
Success Story: Phua Xiong
Field: Family Medicine
Beginnings: Phua Xiong (pronounced PU-a Shong)
was born in Laos to a Hmong family. In 1976, when
she was six years old, her family fled to the United
States and settled in Philadelphia. Nobody in her
family spoke English. Phua was one of the first in
her community to learn the language. As early as
fifth grade she was translating between sick family
members and physicians. “I was often afraid of the
school environment because there was no one I
could identify with,” she says.
Dr. Xiong has used story cloths as a teaching tool to
show how Hmong life in the United States is
different from that in Laos. Her story cloths show
how a change of diet and a settled lifestyle changed
health factors like body weight, fat intake and
exercise. These changes have caused Hmong to
have a new set of chronic illnesses, including high
blood pressure and diabetes. Her story cloths also
show healthy activities like taking walks and
playing in parks. Her video, “Living Healthy
Lives,” highlights cultural aspects of healthy diets.
She became interested in medicine in junior high
school and volunteered in local hospitals. When she
was in ninth grade, her father suggested that she
consider becoming a doctor. That idea was
extremely unusual in the Hmong community, where
girls were generally not encouraged to pursue
education beyond high school. “I was a rebellious
Hmong girl,” Xiong later told Women’s Health
Watch. She challenged herself to learn the sciences,
study hard and do well.
Achievements: Xiong managed to balance having
two children with the demands of medical school.
At the University of Minnesota she helped to start
the Southeast Asian Medical and Dental Students
Association. She was one of the first three women
Hmong physicians in the country. In 1999 she was
named Family Practice Resident of the Year by the
Minnesota Academy of Family Physicians. She coauthored Healing by Heart: Clinical and Ethical
Case Stories of Hmong Families and Western
Providers, published by Vanderbilt University
Press.
Then What?: She attended Haverford College, a
liberal arts college near Philadelphia, where 95% of
the students were white and there were few
minorities. Xiong majored in biology and continued
volunteer work. She recommends that students
interested in medicine find mentoring programs in
fields that interest them, to deepen their
understanding of medicine before going into it.
She completed medical school and her residency at
the University of Minnesota in Minneapolis.
Dr. Xiong, 33, practices medicine in the Model
Cities Health Center, serving a mix of low-income
families. “I like being a spokesperson and advocate
for those who cannot speak up for themselves,” she
says.
Obstacles Faced: Medical school has its own
culture; it can be hard to be a minority and female.
The biggest hurdle there, she says, was maintaining
her self-confidence. “Stand up and prove yourself,”
she advises others. “Don’t give up… Be strong
spiritually and tell yourself, ‘I can do it.’”
Excitement: Comes from interaction with patients
and their stories, and from the challenge of sorting
symptoms into a diagnosis. Dr. Xiong enjoys
learning from her patients about their backgrounds.
She believes that when people are well spiritually,
they often are well physically.
Focus: Dr. Xiong is a health and cultural consultant
for both the Hmong and the larger community in the
36
has also worked in China, Egypt, Haiti, Pakistan
and Sweden.
Success Story: Lydia DeSantis
Even after joining the faculty of the University of
Miami School of Nursing, Dr. DeSantis continued
to challenge herself with education, earning a
master’s degree in public health at the University of
Alabama, Birmingham, in 1993.
Obstacles Faced: Finances and social pressure.
Although her family was supportive, her
grandparents did not like to think of her on her own
in a city. “They had a strong concept of family and
didn’t really like the idea of me leaving for long
periods to work…but my mother understood.”
Field: Cross-cultural nursing
Beginnings: Lydia DeSantis grew up in a small
town southwest of Pittsburgh, Pennsylvania. She
lived with her grandparents, who had immigrated
from Italy, and her mother. Visitors who recalled
Italy gave her a view of a broader world.
Focus: At the University of Miami, Dr. DeSantis
works with an international outreach program and
helps incorporate culture into how healthcare is
provided, and “to integrate the concept and content
of culture through all levels of the nursing
curriculum.” Her work with Miami’s Haitian
immigrant community has attracted international
attention.
Her family leased the top floor of their house to two
women who were nurses. In addition to their
stories, Lydia enjoyed hearing about the
experiences of an older relative who was an
occupational health nurse. In high school, she did
well in math and science, but her family didn’t have
enough money to send her to college.
Achievements: DeSantis, 62, has helped to create
a new major in the nursing school called
Population-based Community Health Nursing, in
which nurses partner with communities to develop
health programs for the community, while gaining
skills for serving that particular community and
culturally diverse groups.
Then What?: She decided to enroll in a three-year
nursing diploma program at Allegheny General
Hospital and received her diploma in 1960. She
viewed nursing as a set of transferable skills that
would allow her to travel.
Dr. DeSantis is especially proud of her work with a
colleague launching the university’s first truly
interdisciplinary course, which examines alternative
healing through the perspectives of anthropology,
nursing and the behavioral and natural sciences. In
the field-study component, students go into
communities and explore how residents use
alternative healing methods, which can include
acupuncture, Chinese medicine, art or pet therapy,
homeopathy, massage and more.
She found that to advance in nursing she would
need a higher degree, so she took more classes
while she worked. She got scholarships to study at
the University of Pittsburgh, where she earned a
Bachelor of Science in nursing. She then applied to
the federal government for support to get her
master’s of nursing education degree, also from the
University of Pittsburgh.
DeSantis worked for Project Hope on a hospital
ship that provided health care and education at
points all around the world. She spent one year in
Tunisia, North Africa, and a second year in
Jamaica. Contact with other cultures led her studies
in another direction, and she earned a Ph.D. in
anthropology at the University of Washington. She
Excitement: “You meet great people along the
way and you learn from them,” she says. “You can
change your focus as you keep building on your
basic nursing education,” she says. “Humanities,
biology and the social aspects of life all combine in
nursing. You can always challenge yourself.”
37
Focus: Bringing together the best observations
about plants and treatment from traditional African
healing methods and the best from Western
medicine. Dr. Iwu has developed a process for
discovering medicines that also provides income for
rural people and natural conservation.
Success Story: Maurice Iwu
Beginnings: Maurice Iwu grew up in the Igbo
(pronounced E-bo) community of Aba, in Nigeria,
West Africa. “My entire extended family were
traditional healers,” he says. “For me, medicine was
a natural.” But the tensions between traditional
healing and western medicine posed obstacles.
Achievements: In the 1980s, Dr. Iwu received a
Fulbright Fellowship to work in the United States at
the Walter Reed Army Hospital in Bethesda,
Maryland, to help find new medicines against
malaria, a deadly virus found in many parts of the
tropics. For a time, Dr. Iwu also worked as vice
president of product research for Tom’s of Maine, a
progressive company, developing plant-based
personal-care products. Later he left the company to
dedicate more time to a new program on drug
discovery, funded by the National Institutes of
Health.
Then What?: Iwu finished secondary school in
Nigeria and then attended college in England, at the
University of Bradford. He completed his university
degree there and postgraduate studies in
pharmacognosy, the study of medicines derived
from nature. He then returned to Nigeria to teach at
the University of Nigeria at Nsukka.
In searching for new medicines from plants, Dr. Iwu
wants to make sure that harvesting plants for
medicines today does not destroy the plant
populations of tomorrow. He believes that the
process of discovering new medicines can also
benefit the rural people where the plants grow and
help conserve the natural resource there.
Obstacles Faced: The first major obstacle he faced
was mastering both western and African medical
traditions. “You have to understand both systems to
see what each brings to healing,” Iwu says. “It’s a
lot of work.”
His greatest satisfaction is the support he has gained
to find plant-based drugs for serious illnesses. One
natural compound that he discovered in an African
plant used for chewsticks (like toothbrushes)
appeared to fight the deadly Ebola virus. “The hope
exists for more solutions,” he says.
After returning to Nigeria, Dr. Iwu found, “The
biggest problem was from the elite in Nigeria, who
thought that traditional medicine was backward and
for the uneducated.” They thought that his approach
— to combine traditional African healing and
Western medicine — didn’t make sense. This
closed-mindedness frustrated Iwu. He saw a way to
combine modern medicine with traditional African
healing tools from plants.
Excitement: Raising respect for traditional healers
in Nigeria and Cameroon. Recognition like the NIH
grant for research with traditional healers has
helped defeat the notion that traditional medicine is
without value. Dr. Iwu, 52, says, “I feel so honored
to be living at a time when such changes are taking
place.”
Field: Drug Discovery from Nature
38
Success Story: Benjamin Young
Obstacles Faced: None of his friends was interested
in school and many dropped out of high school.
College was unfamiliar. He didn’t know about his
options for college or how it could help him, and he
had no incentive to find out. “Intellectual curiosity
needs to be developed in young people,” he says now.
Another obstacle was that Young’s family couldn’t
afford college. His scholarships made a big difference.
“I will never know who on the admissions committee
at Howard spoke up for me, but I will always be
grateful,” he says. “Success means giving back.”
Field: Psychiatry
Beginnings: Benjamin Young was born the youngest
of nine children into a family of Native-Hawaiian and
Chinese background. Young grew up in Hawaii,
where his mother worked in a Dole pineapple cannery
and his father worked as a janitor at the nearby Air
Force Base.
In medical school in those days, the faculty could
make you feel embarrassed if you didn’t know the
latest practices. He says that medical faculty now have
become more sensitive to students’ problems.
“Surround yourself with good mentors and maintain
your link to family and your culture, whenever
possible.”
When Ben was in the second grade, his father suffered
a stroke and could no longer work. The family fell on
hard times financially. Ben was not interested in
school or in science, and none of his friends were
going to college. He was headed for a life of work in
the pineapple fields.
Focus: As director of the Native Hawaiian Center of
Excellence at the University of Hawaii’s John A.
Burns School of Medicine, Dr. Young, age 62, trains
people in areas of medicine especially important to
Native Hawaiians’ health, such as cardiovascular
health, diabetes and drug abuse prevention. He helps
ensure that the medical school curriculum addresses
Native Hawaiians’ concerns with good information
resources (books and videos) and an active network
for distributing them throughout Hawaii.
Then What?: In Young’s senior year of high school,
a minister saw his potential and tutored him in science
and other subjects. Young’s grades improved, and
with the minister’s help he was accepted at Kentucky
Christian College, in eastern Kentucky. He became
the first member of his family to go to college when
he made the long plane journey to the mainland U.S.,
and on to Appalachia.
Achievements: One of his favorite experiences was
building a traditional canoe with a team of other
Hawaiians, and using it to voyage from Hawaii to
Tahiti and back. The journey took 22 days outbound,
and three days for the return (due to trade winds). It
was described in the October 1976 issue of National
Geographic.
At college, Young helped to pay for his education by
shoveling coal in the mountain coal mines. He
finished his Bachelor’s Degree in English Literature at
Milligan College in Tennessee and moved to
California.
His greatest satisfactions come from ongoing contact
with Hawaiian culture and his role in helping people
develop their careers in ways that fit with their
culture.
Young realized that he wanted a career related to
medicine. He received a scholarship to attend medical
school at Howard University in Washington, D.C. He
first considered ophthalmology and dermatology, then
he called several hospitals back in Hawaii to find out
what medical specialties were most needed there. He
was told there were openings for psychiatrists, so he
went into psychiatry. When he finished his residency
at the University of Hawaii, he became the first Native
Hawaiian in psychiatry.
Excitement: “Seeing young people become pillars of
the community and meet community needs is
wonderful,” he says.
39
In His Own Words: A Mentor’s
Legacy of Confidence
prodding and prompting, I did further my
education. I am very thankful that he encouraged
me to do that….
He continually encouraged me. There was one
incident in particular I will always remember. I was
working with a doctor who became ill in the middle
of the surgery. When Vivien got wind of this, he
immediately came into the lab and said, “What is
the problem?”
I said, “Dr. Saharia is ill, and we can’t continue
this.” And Vivien’s reaction was, “Why not?” And I
looked around and repeated, “We can’t continue
this.” And he said, “You go ahead. You finish it.” I
couldn’t say no. Here’s the supervisor telling me,
“You’ve got to go finish this.”
Fred Gilliam came to Johns Hopkins in the 1970s
as a high school student in an apprentice program
for which Vivien Thomas was the mentor. Under
Thomas’ supervision, Gilliam worked his way up to
be a surgical lab technician. His recollections show
how Vivien Thomas inspired the people around
him.
So I continued on, and finished the procedure. And
from that point on, I became independent
surgically…That is one thing that I will always
remember. He gave you the confidence to never say
No. His attitude was, “If it can be done, I will do
it.”
I would describe my relationship with Vivien as sort
of a father-son relationship. When I came to
Hopkins as a high school freshman, I think he saw
my desire to learn the job and to be a part of what
was happening there. I didn’t really know a lot
about his past or his background.
Gilliam was not the only youth affected by Vivien
Thomas. Thomas actively recruited new people who
he thought had qualities that would allow them to
thrive in the lab. He even tried to recruit people
already employed in other occupations at Hopkins.
Raymond Lee, who came to Hopkins in the 1950s,
was one of those employees.
As a teacher, he was excellent. If you had the desire
and the willingness to learn, Vivien would spend
countless hours looking over your shoulder.
Vivien was very, very sincere about every individual
being responsible as an individual. And by that I
mean regardless of color. If you could do your job
and gave respect, you should be respected. He
constantly told us, “If somebody talks down to you
or doesn’t ask you a question in the correct manner,
don’t do it.”
When I first started here, I started in the
housekeeping department, but I moved from the
housekeeping department to the elevator. And Mr.
Thomas would use my elevator to go up and down,
and to go from the first floor to the 12th floor. And
he had taken a liking to me, and he felt as though I
would be good in his lab, in Dr. Blalock’s lab.
Vivien taught us so that we could teach. He wanted
us to be much more than the average lab worker.
And he wanted us to feel that we were important
and a part of what was going on. He stressed that
every day.
He saw something in me that I didn’t know I had.
He believed that if you met the right people at the
right time and you could prove yourself, then you
could achieve what you were meant to do.
He was a stickler for education. From my first day
here, he would say, “You are going to get some
education. Don’t be complacent and feel content
that you are going to work here. I want you to go
further your education.” And because of his
Vivien Thomas took his role as mentor to these
young men and women very seriously. According to
Jean Queen, who joined the laboratory from
Hopkins Central Supply in 1969, Thomas was
40
always trying to instill in his protégés a sense of
pride and accomplishment beyond what was
expected.
In laboratories in other institutions, the
technician’s job was to get the animal, clean the
instruments, clean up the trash, and don’t voice any
opinions or act like you knew what was going
on…With Mr. Thomas, your job was to learn
surgery. A lot of times, when the doctors came in,
he had taught you so much that they would assist
you.
He would train so that [the technicians] would
learn how to do pediatric surgery, cardiac surgery,
any kind of surgery that was going on the floor. He
would teach you how to do it so you could fill in at
any spot.
Vivien Thomas’ lessons were applicable to more
than just science. To Queen, now the purchasing
agent for Hopkins’ Minimally Invasive Surgery
Training Center, Thomas’ legacy not only taught
these young men and women how to excel in the
lab, but also inspired them how to live.
Vivien Thomas’ Surgical Lab at Johns Hopkins
We had one [doctor] who would always call you
“boy” when he wanted you to come. Mr. Thomas
would say, “Don’t get up. Don’t go out there
because he knows your name and if he doesn’t know
your name, than he can ask somebody your name.
So don’t go out there; let him call you by your
name.”
[Vivien’s legacy is] not to sit back and wait for
someone to tell you what to do. To learn as much as
you can learn…to do the best job and to do it right
the first time. To have consideration and
understanding for other people. To always walk tall
and proud …
To always take a step beyond.
41
6. Resources
Scholarships
Vivien Thomas Scholarship Information
http://www.cbcfinc.org/gsk_scholarship.html
Vivien Thomas High School Research Program at the Morehouse School of Medicine
www.carsonscholars.org
e-mail: [email protected]
Books
Partners of the Heart: Vivien Thomas and His Work with Alfred Blalock, autobiography by Vivien T. Thomas,
University of Pennsylvania Press, reprinted 1998. First printing 1985.
Gifted Hands: The Ben Carson Story, by Ben Carson, M.D., Zondervan Publishing House, 1997.
The Spirit Catches You And You Fall Down, by Anne Fadiman, Farrar, Straus and Giroux, 1997.
Speak Now Against the Day: The Generation Before the Civil Rights Movement in the South, by John Egerton,
Knopf, 1994
The African-American History of Nashville, Tennessee, 1780-1930: Elites and Dilemmas, by Bobby L. Lovett,
University of Arkansas Press, 1999.
Websites
Partners of the Heart website
http://www.pbs.org/wgbh/amex/
New York Times Learning Network — gives background to today’s news and events
http://www.nytimes.com/learning/students/index.html
History everywhere
http://www.hyperhistory.com/online_n2/History_n2/a.html
Heartpoint health information
http://www.heartpoint.com
Science Training Programs Directory – over 300 programs listed in science, mathematics and engineering
http://www.sciserv.org/stp/
Science Fairs everywhere
http://physics.usc.edu/~gould/ScienceFairs/
National Institutes of Health (NIH) site on high school opportunities
http://grants.nih.gov/training/careerdev/hsopporte.html
NIH site on internships, scholarships more
http://science-education.nih.gov/homepage.nsf/for+students?OpenForm
NASA Education Programs – aerospace, earth science, space science, and biophysical research
http://education.nasa.gov
42
Student Opportunities at NASA
http://www.nasajobs.nasa.gov/jobs/student_opportunities/temporary_stay.htm
Websites related to success stories
Dr. Vivien Thomas
Johns Hopkins Medical Archives
www.med.jhu.edu/medarchives/vthomas.htm
Dr. Alfred Blalock
Johns Hopkins Medical School
www.med.jhu.edu/medarchives/tblbio.htm
Dr. Levi Watkins
Johns Hopkins College of Surgery
www.csurg.som.jhmi.edu/faculty/lwbio2.htm
Dr. Henry Wall
GlaxoSmithKline pharmaceutical maker
www.gsk.com
Dr. Phua Xiong
Family medicine specialist
www.womenspress.com/newspaper/2001/17-11xio.html
Dr. Maurice Iwu
Bioresources Development and Conservation Program
www.bioresources.org/
Dr. Bevin Engelward
MIT lab for DNA repair systems
http://web.mit.edu/bevin/www/
Dr. Rodney Hood
National Medical Association
www.nmanet.org/
Dr. Maria Terésa Tarragó-Trani
Virginia Tech University
www.vt.edu
Dr. Lydia DeSantis
University of Miami School of Nursing
www.miami.edu/UMH/CDA/UMH_Main/1,1770,5926-1,00.html
Dr. Benjamin Young
Native Hawaiian Center of Excellence
University of Hawaii, John A. Burns School of Medicine
www.hawaii.edu/nhcoe/
More Health and Medical Outreach Organizations
American Medical Association – Adolescent Health Online
http://www.ama-assn.org/ama/pub/category/1947.html
National Hispanic Medical Association
http://home.earthlink.net/~nhma/
43
Latin American Research Service Agency
http://www.larasa.org/
Asian and Pacific Islander Health Forum
http://www.apiahf.org/
Association of American Indian Physicians – Indian Health Network
http://www.aaip.com/home/index2.html
For Teachers
Social History
Facing History and Ourselves
Examining human behavior
http://www.facing.org/facing/fhao2.nsf
Science
The Why Files: Science Behind the News
http://whyfiles.org/
PBS Scientific American Frontiers
http://www.pbs.org/saf/educators.htm
Study guides and materials for a variety of topics,
including vocabulary, discussion questions, and activities
http://www.aande.com/class/teach/index.html
Women and Math Mentoring Program
Includes cool stuff on a range of science
and engineering topics, too
www.WomenAndMathMentoring.org
America’s Promise, a national mentoring program
http://www.americaspromise.org/
Online mentoring in biology subjects
http://www.idcnet.com/~cstewart/elnkbio.htm
Open Directory Project list of Science Mentoring Programs
http://dmoz.org/Science/Educational_Resources/Mentoring_Programs/
Other Resources
National Urban League
http://www.nul.org
44
NAACP
http://www.naacp.org
Careers in Emergency Medical Services
http://www.baldwinems.com/justforkids.htm
About the Career Mentoring Process for Teenagers
Site posted by the University of Michigan
http://www.eecs.umich.edu/mathscience/exploringsci/MenProcess.html
Project Resilience
http://www.projectresilience.com/
Cultural competency in medicine. American Medical Students Association, Reston, VA.
www.amsa.org/programs/gpit/cultural.cfm.
7. Acknowledgments
Viewer’s Guide by: David Taylor
Graphics by: Wanakhavi Wakhisi
Contributing Writers: Denise Couture, James Mirabello
We are grateful for the contributions of many people in making this guide: Monte Achenbach, Allegra
Chatterjee, Nathan Crippens, Audrey Davis, Lydia DeSantis, John Egerton, Bevin Engelward, Joe Flynn,
Mychalene Giampaoli, Rodney Hood, Stan Hull, Maurice Iwu, Lallitha John, Amber Jones, Andrea Kalin,
Bobby Lovett, Thais McNeal, Josh Rosenthal, Karen Simon, Lisa Smith, Maria Terésa Tarragó-Trani, Henry
Wall, Levi Watkins, Melissa Wener, Phua Xiong, Benjamin Young and Shannon Graphics.
45
FUNDING FOR
IS PROVIDED BY:
NATIONAL
ENDOWMENT
FOR THE
HUMANITIES
AND
COMMUNITY AND EDUCATIONAL OUTREACH SUPPORTED BY:
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